What are skin tags and how are they removed?

Skin tags are small, benign flaps of tissue that hang off the skin, usually found on the neck, torso, or groin. Tags typically appear brown or flesh-colored and are thought to be caused by rubbing of the skin in folds or creases. They are particularly common in women during pregnancy, though almost anyone is susceptible.

Even though skin tags are harmless, they can be a nuisance, and are easily removed by electrocautery or freezing by liquid nitrogen. If you have a skin tag you would like removed, give our office a call today to schedule an appointment to easily remove the pesky growth.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Can blisters on the skin mean allergy to a medication?

Bullous Pemphigoid with secondary bacterial infection. Caused by an allergy to hydrochlorthiazide diuretic.
Bullous Pemphigoid with secondary bacterial infection. Caused by an allergy to hydrochlorthiazide diuretic.

Yes. In particular there is a condition known as bullous pemphigoid. This eruption consists of blisters scattered over different parts of the body. It is considered to be either a drug  (medication) rash or one that is autoimmune (not caused by medication but by the body’s own immune process).

The most common class of drugs that cause bullous pemphigoid are the sulfa drugs. These drugs can range from certain diuretics, antibiotics, anti-inflammatory drugs to diabetic medications. The rash is extremely itchy. This eruption can also develop a secondary bacterial infection resulting in crusted lesions scattered all over the body.

Bullous pemphigoid must be treated by eliminating the offending medication, as well as topical and systemic therapy.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Can a summertime rash that looks like insect bites be something else?

Shingles
Shingles (Herpes Zoster) looking like summer insect bites

There is a condition commonly known as Shingles, which is medically known as Herpes Zoster. This is not related to the STD Herpes Simplex. It represents a reinfection with, or a reactivation of, the chickenpox virus. The rash consists of small fluid-filled bumps on the surface of the skin in clusters. These clusters may be small, as in the photo shown, or can wrap around one side of the body in a Shingles-like fashion.

The treatment for this rash is very different from the treatment for insect bite reactions. Individuals who experience itching, burning and/or tingling and pain with a rash as described should see a dermatologist for anti-viral treatment, as well as medication for pain and itching.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What can I do about summertime athlete’s foot?

Athlete’s foot is more of a problem in the summer because of the heat and sweat allowing a good environment for fungus to grow. The over-the-counter anti-fungal medications can frequently work very well to alleviate the symptoms of itching and discomfort.

Athlete’s foot is a fungus infection resulting in scaling and itching of the involved skin. It is more common in men, but women can also get it. The over-the-counter anti-fungal medicines are usually very effective; however, sometimes if the areas between the toes are moist and oozing, it is better to use a liquid treatment rather than a cream. An over the counter antiseptic spray, such as one containing benzalkonium chloride, can be useful for the moist infections in between the toes.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What can be done for large pores on the nose?

Large pores on the nose can be genetic or the result of excess oil accumulation in the pores. The pores are actually passageways through which the body’s oil (sebaceous) glands normally secrete oil. If oil secretion is excessive or if the pores are clogged at the surface, the accumulation of oil can darken and become what are known as open comedones (blackheads). Large pores on the nose can also be seen with a condition known as rosacea, which is treated similarly but more aggressively.

It is helpful to avoid moisturizing the nose as this only adds more oil to the area. Drying and peeling agents are very effective to reduce the size of the pores. Our oily skin cleanser, when applied to a gauze pad or washcloth and gently rubbed on the open pores twice a day is very effective in minimizing the oil content of the pores. Additionally, facial acid treatments/chemical peels are very effective for minimizing this condition. Our Sal-Hydro™ helps dissolve, as well as lighten, the material within the pores. In our office, we do mild chemical peeling with trichloroacetic acid, which is also highly effective in reducing the pore size. Occasionally instrument extractions are used, however this must be minimally done and only under specific circumstances and only in a dermatologist’s office under sterile conditions.

I highly recommend that instrument extractions or manual extractions of any kind not be done at home or in any other facility besides a dermatologist’s office. This is not only because of problems with sterility outside the dermatologist’s office but also because improper squeezing of the nose can lead to irreparable scarring and permanently enlarged pores. The use of non-sterile instruments, fingers, tissues, or cotton swabs, which is frequently done outside of a dermatologist’s office can result in infection and more scarring.

The secretion of oil by the sebaceous glands on the nose is a normal biological process. Consequently, the production of oil will continue and treatment is ongoing. In particular circumstances, we use Botox or Dysport injections to decrease oil production. I cannot stress enough how important the treatment of this condition should be confined to a dermatologist’s office as I have seen numerous problems with infections and permanent scarring when this situation is approached by well-meaning others.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What should you avoid if you are allergic to poison oak?

Poison oak is now prevalent in southern California. For those of you who have ever had a poison oak allergy, it is now time to be particularly careful. Hiking areas and even park grounds can hide this devious culprit. You must be vigilant in trying to avoid contact, especially during this time of year.

Some of the things that you might want to consider would be avoiding rubbing up against any kind of brush/trees/bushes while walking or running outdoors and avoiding all fires made with wood or branches where poison oak may be growing as the smoke is a strong allergen for every part of the body with which it comes in contact.

I recently saw a patient who had been carrying pieces of wood across his arm while clearing brush. The wood had been in contact with poison oak, and the bark had rubbed the resin into his skin.

The rash seen from poison oak is red, itchy, and frequent blistering. In many areas, a linear scratch can be observed.

Poison oak on black skin reacts similarly to the allergies on whiter skin; however, the lesions may be harder to diagnose and differentiate from other skin conditions.

In addition to the allergic reaction, poison oak frequently becomes secondarily infected, which can add honey-colored crusting to areas that have been scratched. The rash tends to be intensely itchy.

Initial treatment at home can be over-the-counter 1% hydrocortisone cream applied frequently throughout the day, as well as calamine lotion to the blistering areas. Over-the-counter Polysporin ointment (not any neomycin containing ointments) can be applied to any bacterial infected areas producing these honey-colored crusts.

A poison oak allergic reaction can be very serious and extremely uncomfortable. If at-home treatment doesn’t significantly help, a visit to your local dermatologist is highly recommended.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

Do campers need to take special skin care precautions?

Poison Oak

Absolutely. If you are going camping, your skin will be exposed to unusual conditions. If you want to protect your skin, you should always apply a sunblock such as our Bussell Skin Care Sunblock SPF 30. A hat and sunglasses should also be worn because of sun damage to the eyes that can cause eye conditions such as cataracts.

Campers are also exposed to insect bites, poison ivy and poison oak. Insect repellent can sometimes irritate your skin. I advise spraying clothing with insect repellent rather that spraying your skin. Do this outside in a well-ventilated area. If you are allergic to insect bites or stings, I advise bringing with you a dose of epinephrine in the form of an Epi-pen, but you should consult a physician to understand how to use it. Individuals who are allergic to bee stings should always camp with an Epi-pen in their backpacks if they are severely allergic. It is always wise to have an emergency number you can call in case of a severe allergic reaction during your camping trip.

Many people are allergic to poison ivy and poison oak to some degree. Poison ivy is generally found on the East coast and poison oak on the West coast. The type of allergic reaction caused by these plants is known as a rhus dermatitis. If you are camping, you should bring along with you a bottle of calamine lotion to soothe skin rashes caused by these plants. Make sure you know how to identify these plants in order to avoid them. I also suggest keeping your lower legs covered with socks and long pants.

Poison Ivy

A little known way of getting a severe poison oak or poison ivy rash is from campfires. Be careful not to put wood containing these plants into a campfire as the smoke can cause a very severe allergic reaction as it tends to diffuse all over the skin’s surface.  Carrying antihistamines to take for a poison oak/poison ivy reactions or reactions to insect bites can be very helpful.

Campers and hikers may also find that they perspire in their shoes. This can lead to an ideal environment for fungus or athlete’s foot to thrive. Changing socks as soon as they feel moist, adding foot powder in the socks and shoes and wearing shoes that breathe can all help reduce the chances of a fungus infection developing during your trip.

If you are hiking in an area known to have snakes, try to stay on the hiking path and wear high top shoes or boots. Also bring along a little emergency kit filled with first aid supplies, antibacterial wipes and Tylenol, aspirin or ibuprofen for pain, keeping in mind that aspirin or ibuprofen can cause a bleeding wound to clot less easily.

Related post: What should you avoid if you are allergic to poison oak?

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661

What can you do for keratosis pilaris?

Keratosis pilaris is a condition that produces small, firm bumps on the sides of the upper arms and sometimes the upper legs and buttock area. It is frequently seen in patients with asthma, hay fever, and eczema. In my office, we find that peeling the areas with trichloroacetic acid is very effective in making the involved skin smoother and softer. At home, I recommend that my patients use my antibacterial soap to wash these areas.  This minimizes the germ count on the skin and additionally helps dry and peel away these plugged follicles. I also recommend the use of my vitamin moisturizer on wet skin in these areas twice a day to smooth and soften.

Keratosis pilaris is a chronic, ongoing condition that can be treated but not cured.

– Dr. Bussell

Beverly Hills Dermatology Consultants

433 N. Camden Drive, Suite 805   Beverly Hills, CA 90210 | 310-550-7661